From Washington, DC,

• The Department of Health and Human Services announced that
  • “21.3 million people selected an Affordable Care Act Health Insurance Marketplace plan during the 2024 Open Enrollment Period. Total plan selections include more than five million people — about a fourth — who are new to the Marketplaces and 16 million people who renewed their coverage. Notably, open enrollment continues in four states and Washington, D.C., through January 31.
  • “For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind — Medicare, Medicaid, and Social Security, but now it’s crystal clear that we need to add a fourth — the Affordable Care Act,” said HHS Secretary Xavier Becerra. “Once again, a record-breaking number of Americans have signed up for affordable health care coverage through the Affordable Care Act’s Marketplace, and now they and their families have the peace of mind that comes with coverage. The ACA continues to be a successful, popular, and important federal program to millions of people and their families. As we celebrate the success of this most recent enrollment effort, HHS will double down on the Biden-Harris Administration’s efforts to increase access to quality care and lower costs.”

• The Peterson-KFF Health System Tracker identifies “Health Cost and Affordability Policy Issues and Trends to Watch in 2024.”

From the public health and medical research front,

• Beckers Hospital Review informs us,
  • “After discontinuing the use of semaglutide and liraglutide weight-loss medications, a majority of patients were able to maintain the same weight they were at when halting the use — or even continued to lose additional weight after one year, a new study revealed. 
  • “The research, published Jan. 23 in Epic Research, focused on the outcomes of 20,274 patients who were prescribed semaglutide and 17,733 patients prescribed liraglutide, who lost at least five pounds while taking it. 
  • “Sustained weight loss slightly differed for the drugs — 56.2% of patients prescribed semaglutide kept the weight off one year after discontinuation of the drug, while that same outcome was 55.7% of patients who took liraglutide.
  • “While the majority were able to maintain their weight or shed additional pounds, some did not, and the outcomes differed by medication type. 
  • “One year after discontinuation of semaglutide medications, 17.7% regained all the weight they had lost while on the medication, and some even gained additional weight. For liraglutide, 18.7% entirely regained their weight one year after halting use.

• Medpage Today tells us,
  • “Infants born to unvaccinated mothers who had COVID-19 during pregnancy were at high risk for developing neonatal respiratory distress, the longitudinal, cohort COMP study found.
  • “The odds of developing respiratory distress were threefold higher (OR 3.06, 95% CI 1.08-10.21) in infants born to unvaccinated mothers diagnosed with COVID-19 while pregnant compared with COVID-exposed infants born to COVID-vaccinated mothers, Mary Catherine Cambou, MD, of the University of California Los Angeles (UCLA), and colleagues reported in Nature Communications.
  • “This was not something we were expecting to see, as none of the babies were diagnosed with COVID-19 themselves,” co-author Karin Nielsen-Saines, MD, also from UCLA, told MedPage Today in an email. “We also noted that respiratory distress was not transient and lasted several days.”
  • “However, when pregnant participants had received at least one mRNA vaccine dose prior to SARS-CoV-2 infection, the odds of their infants developing neonatal respiratory distress dropped to 0.33 (95% CI 0.10-0.96) — a 67% decline, the authors pointed out.”

• The National Institutes of Health announced,
  • “Researchers at the National Institutes of Health have found overactivation in many brain regions, including the frontal and parietal lobes and the amygdala, in unmedicated children with anxiety disorders. They also showed that treatment with cognitive behavioral therapy (CBT) led to improvements in clinical symptoms and brain functioning. The findings illuminate the brain mechanisms underlying the acute effects of CBT to treat one of the most common mental disorders. The study, published in the American Journal of Psychiatry, was led by researchers at NIH’s National Institute of Mental Health (NIMH). 
  • “The findings can help our understanding of how and for which children CBT works, a critical first step in personalizing anxiety care and improving clinical outcomes,” said senior author Melissa Brotman, Ph.D., Chief of the Neuroscience and Novel Therapeutics Unitin the NIMH Intramural Research Program. * * *
  • “This study provide evidence—in a large group of unmedicated youth with anxiety disorders—of altered brain circuitry underlying treatment effects of CBT. The findings could, in time, be used to enhance treatment outcomes by targeting brain circuits linked to clinical improvement. This is particularly important for the subset of children who did not significantly improve after short-term CBT.
  • “The next step for this research is to understand which children are most likely to respond. Are there factors we can assess before treatment begins to make the most informed decisions about who should get which treatment and when? Answering these questions would further translate our research findings into clinical practice,” said Brotman.”

• BioPharma Dive reports,
  • “An 11-year-old boy who was born deaf can hear after receiving an experimental gene therapy, developer Eli Lilly reported on Tuesday.
  • “The boy, identified as Aissam Dam by The New York Times, was the first participant treated in a small study Lilly is running to test the therapy, which is designed to correct a particular type of inherited hearing loss.
  • “While only from one person, the result is a striking example of gene therapy’s potential. According to Lilly, Dam experienced restored hearing across sound frequencies within a month of treatment. In some frequencies, Dam’s hearing was within the normal range at day 30, Lilly said.
  • “Lilly plans to present full data from Dam, as well as a second participant in its study, at a medical conference in early February.”

From the U.S. healthcare business front,

• Healthcare Dive lets us know,
  • “Elevance Health raked in $6 billion in profit last year on revenue of more than $171 billion — a better performance than Wall Street expected, given that high medical costs have been dogging payers.
  • “The payer beat analysts’ consensus expectations for earnings and revenue in the fourth quarter of 2023, with a topline of $42.7 billion, up 7% year over year. Elevance’s fourth-quarter profit of $831 million was down, however, by 5% year over year.
  • “Elevance chalked its revenue growth up to higher premiums and growth in its pharmacy benefit manager CarelonRx. Analysts said the Indianapolis, Indiana-based payer also benefited from better-than-expected medical costs and higher investment income in the quarter.” 
• and
  • “Walgreens is considering a sale of its specialty pharmacy business Shields Health Solutions as the struggling retail chain attempts to improve its halting finances, according to a Bloomberg report. 
  • “Shields could be valued at more than $4 billion in a sale, and a deal might appeal to private equity firms or healthcare companies, Bloomberg said, citing sources familiar.
  • “Walgreens is in the midst of a shift to focus on delivering healthcare services to payer, provider and pharmaceutical clients. But the company’s U.S. Healthcare division — which Shields is a part of — isn’t currently profitable.” 
• and
  • “HCA Healthcare’s outpatient surgery operator Surgery Ventures has acquired majority interests in two ambulatory surgical centers in North Texas, the for-profit hospital operator announced on Monday.
  • “The centers are now affiliated with HCA subsidiary Medical City Healthcare, which runs 19 hospitals and 15 surgery centers in the region.
  • “The purchase comes after HCA, one of the largest hospital operators in the country, has made other recent acquisitions in Texas, which is one of the chain’s largest markets.” 

• Per BioPhama Dive,
  • “Johnson & Johnson CEO Joaquin Duato sold 2023 as a “remarkable year” on an earnings call with investors Tuesday. But the pharmaceutical giant faces looming difficulties that hang over its performance, including incoming biosimilar competition to its blockbuster immune drug Stelara and a $700 million settlement over claims the company’s talc product caused cancer.
  • “As far as last year goes, J&J narrowly beat Wall Street’s expectations with $85.2 billion in revenue. Pharma sales grow 9.5% in the fourth quarter compared to the same period the year before. Cancer treatments and immunology medicines like Stelara made up the bulk of that revenue.
  • “As one of the largest pharma companies and often the first in the sector to report earnings each quarter, J&J is often considered a sort of bellwether for the industry.”
• and
  • “Novo Nordisk is adding yet another prospect to its obesity drug pipeline, this time from a biotech company spun out of Harvard University and Zurich University. · EraCal Therapeutics tests compounds in larval zebrafish in a bid to trigger behavioral changes related to appetite while minimizing other effects in the body. The Swiss startup says it’s seen early success in mice and may be able to produce a drug that helps people lose weight without the side effects sometimes seen with current treatments. ·
  • “As part of the deal announced Tuesday, EraCal is eligible for payments worth as much as 235 million euros, or about $256 million, as well as royalties if a product reaches the market. The total includes an unspecified amount of money up front, as well as future payments tied to developmental and commercial milestones.”

• North Carolina Public Radio reports
  • “The board that oversees the North Carolina State Health Plan will face a heavy decision Thursday when it considers dropping coverage of weight loss medications like Wegovy. * * *
  • “The State Health Plan is the health insurance plan for more than 740,000 teachers, state employees, retirees, and their dependents. It’s a massive health plan that paid more than $4 billion in claims last fiscal year, according to plan data.
  • “But even at that size, the high costs of these GLP-1 medications take an outsized bite of the pie. In 2023, the 24,750 people with prescriptions of Wegovy, Saxenda, and Zepbound cost the plan $102 million after rebates. In 2024, CVS Caremark, the plan’s pharmacy benefits manager, warned those rebates might lessen or go away completely, something that could push total costs north of $170 million. For context, as recently as 2019-20, the plan paid less than $790 million for all pharmacy claims for the entire fiscal year.”

• Bolton consulting group identifies seven key employee benefit trends for this year.